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Careers at hckd.fa.us2.oraclecloud.com
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600 positions at hckd.fa.us2.oraclecloud.com
Representative, Support Center (Bilingual Spanish)
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Provides level I support center customer service excellence to meet the needs of Molina members and providers. Resolves issues and addresses needs fairly and effectively, while demonstrating Molina values. Provides product and service information, and…
Director, Health Plan Provider Relations
hckd.fa.us2.oraclecloud.com·Jackson, MS, United States
***Remote and must live in Mississippi*** JOB DESCRIPTION Job Summary Leads and directs team responsible for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact betwe…
(RN) Care Manager- Jail Transition Re-entry Program (REMOTE)
hckd.fa.us2.oraclecloud.com·WA, United States
JOB DESCRIPTION Job Summary Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contri…
Community Behavioral Health Liaison BNET Program (Must Reside in FL)
hckd.fa.us2.oraclecloud.com·FL, United States
Job Summary Provides support for community behavioral health coordination activities. Acts as a liaison between the business and community behavioral health/chemical dependency agencies to enable the provision of member behavioral health services. Contributes to overarching str…
Community Connector (Transition Resource Spc) Must Reside in FL
hckd.fa.us2.oraclecloud.com·FL, United States
Provides support for community-based member advocacy activities with regard to transitioning from children services to adult services and preparing for adult responsibilities. Serves as a local member advocate and resource, using knowledge of the community and resources available…
Care Review Clinician, RN/LPN
hckd.fa.us2.oraclecloud.com·CA, United States
JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach des…
Senior Specialist, Provider Engagement- Quality HEDIS Risk (Remote)
hckd.fa.us2.oraclecloud.com·FL, United States
Job Description Job Summary Provides senior level support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes Uses a consultative approach emphasizing physician engagement and behavior change th…
Risk & Quality Performance Manager (Remote)
hckd.fa.us2.oraclecloud.com·FL, United States
Job Description Job Summary The Risk & Quality Performance Manager position will support Molina's Risk & Quality Solutions (RQS) team. This position collaborates with various departments and stakeholders within Molina to plan, coordinate, and manage resources and execute perfor…
Analyst, Delegation Oversight (Remote)
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides analyst support for delegation oversight activities including monitoring delegation oversight to ensure compliance with state, federal, National Committee for Quality Assurance (NCQA), and Molina requirements. Responsible for gathering, coord…
Specialist, IRIS Consulting (Milwaukee, WI)
hckd.fa.us2.oraclecloud.com·Milwaukee, WI, United States
Do you want a career where you build lasting relationships with the people you partner with? Do you want to make a difference in the lives of people with long-term health care needs? Then TMG wants to hear from you! We’re currently looking for someone with a social services …
Manager, Medical Economics - REMOTE
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Leads and manages team responsible for medical economics analysis activities, including extracting, analyzing and synthesizing data from various sources to identify risks and opportunities, and improve financial performance. Collaborates with health p…
Manager, Healthcare Services - Remote (Must Reside in California)
hckd.fa.us2.oraclecloud.com·CA, United States
JOB DESCRIPTION Job Summary Leads and manages multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other…
Care Review Clinician (RN)(Behavioral Health)
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Behavioral Health experience required. Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, an…
CM Delegation Liaison (Case Manager Education Liaison)
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Provides support for clinical liaison delegation oversight activities in conjunction with enterprise partners and multidisciplinary team coordinating integrated delivery of care across the continuum. Contributes to overarching strategy to provide qual…
Senior Specialist, Delegation Oversight (Remote)
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Provides senior level support for delegation oversight activities. Oversees delegated activities to ensure compliance with state, federal, contractual, National Committee for Quality Assurance (NCQA), and Molina requirements. Essential Job Duties • …
Director, Medical Economics - REMOTE
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Leads the design, development, and standardization of healthcare data assets supporting Medical Economics, Finance, Actuarial, and operational business functions. This role is responsible for driving scalable data frameworks, governance practices, a…
Senior Specialist, Quality Program Management & Performance (Remote)
hckd.fa.us2.oraclecloud.com·FL, United States
Job Description Job Summary The Senior Specialist, Quality Program Management and Performance implements new and existing healthcare quality improvement activities to maintain compliance with quality program requirements and reporting and monitoring for key quality program a…
Senior Medical Director (IPA- Based in CA)
hckd.fa.us2.oraclecloud.com·Los Angeles, CA, United States
JOB DESCRIPTION Job SummaryLeads and manages a team of medical directors delivering oversight and expertise in appropriateness and medical necessity of services provided to members - ensuring members receive the most appropriate care in the most effective setting. Contributes to …
Case Management Processor
hckd.fa.us2.oraclecloud.com·FL, United States
JOB DESCRIPTION Job Summary Must reside in Florida. Provides non-clinical administrative support to the care management function, and contributes to interdisciplinary team efforts supporting provision of integrated delivery of care across the continuum. Contributes to over…
Director, Reporting & Analytics - Medical Cost Grouper/Actuary - Remote
hckd.fa.us2.oraclecloud.com·United States
Job Description Job Summary Collects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing and deploying reports to provider networks and other end users for operational and strategic analysis.…
Data Analyst, Provider Configuration
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and app…
Manager, Medical Economics - REMOTE
hckd.fa.us2.oraclecloud.com·United States
JOB DESCRIPTION Job Summary Responsible for leading the refinement, operationalization, and stewardship of enterprise healthcare datasets for Medical Economics use cases. This role focuses on transforming foundational enterprise data assets into trusted, business-ready dataset…
Care Manager, LTSS- MUST Reside in ID
hckd.fa.us2.oraclecloud.com·ID, United States
JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum for members with high-need pot…
Care Manager, LTSS
hckd.fa.us2.oraclecloud.com·Saint Croix Falls, WI, United States
***Remote with member visits throughout Pierce & St. Croix Counties, WI*** JOB DESCRIPTION Job Summary Provides support for care management/care coordination long-term services and supports specific activities and collaborates with multidisciplinary team coordinating integrat…